Healthcare Provider Details
I. General information
NPI: 1336951201
Provider Name (Legal Business Name): BALLARD PHYSICAL THERAPY & SPORTS MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/27/2025
Last Update Date: 02/27/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
925 N US HIGHWAY 69
HUXLEY IA
50124-9738
US
IV. Provider business mailing address
925 N US HIGHWAY 69
HUXLEY IA
50124-9738
US
V. Phone/Fax
- Phone: 515-597-3030
- Fax: 515-597-3303
- Phone: 515-597-5512
- Fax: 515-597-5292
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
LYNZY
LENTZ
Title or Position: OWNER
Credential: DPT
Phone: 641-420-7919